Narcotic pain medications are frequently prescribed in the US for the treatment of acute and chronic painful conditions such as postoperative pain control, reflex sympathetic dystrophy, and degenerative arthritis flare ups.

Narcotics may be very effective, but they are not without risks. One of the most concerning risks is that of overdose, which may be fatal. It is very important not to take more than the prescribed dose, and also not to mix various sedating narcotics together or with other substances that may potentiate this effect. This may include alcoholic beverages or benzodiazepines like Valium.

Although overdoses are regularly seen in the public eye such as when a celebrity dies from one, they occur way too often. Sometimes patients overdose on narcotics on purpose, but typically it’s just not being cognizant of the various cumulative effects. If a patient has severe pain, he or she may just simply take more and more out of desperation, with an unintended fatal result.

Less harmful side effects are very common and may include drowsiness, dizziness, lightheadedness, or nausea or vomiting (usually at first). Dry mouth is also common, which if experienced over a long period may lead to tooth decay. In addition, one may see headache, loss of appetite, restlessness, nervousness, nightmares, blurred vision, and constipation.

One major risk of narcotics is tolerance. This is when patients require increased amounts of narcotics to achieve the same effect of pain relief. This may result in a vicious cycle of narcotics with the patient needing substantially more than what their disease condition should require.

Additional potential complications may include cold, clammy skin, bluish discoloration of the skin, extremely small pupils, serious difficulty breathing or extremely slow breathing, extreme sleepiness or unresponsiveness, confusion, severe drowsiness, slow heartbeat or low blood pressure.

In addition to these risks, patients taking these medications should inform their physician prior to taking narcotics:

· Central nervous system (CNS) depressants, such as antihistamines.

· Monoamine oxidase (MAO) inhibitors, such as phenelzine (Nardil) and tranylcypromine (Parnate).

· Tricyclic antidepressants, such as amitriptyline (Elavil).

· Anti-seizure medicines, such as carbamazepine (Tegretol).

· Muscle relaxants, such as cyclobenzaprine (Flexeril)

· Sleeping pills, such as triazolam (Halcion)

· Blood-thinning drugs, such as warfarin (Coumadin)

· Naltrexone (Trexan, Revia). Cancels the effects of opioid analgesics.

· Rifampin (Rifadin)

There are quite a few narcotics that come with acetaminophen in the mix, which can be harmful to the liver if too much is taken. So care should be taken not to take over 4 grams per day total.

Once again, extreme care should be taken with narcotic medications and one should make sure he or she is under the care of a physician and only taking them according to the prescribed dose.

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